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Amnio Wrap2

Pennsylvania rates for HCPCS Q4221

Amnio Wrap2, per sq cm (add-on, list separately in addition to primary procedure)

Rates data updated July 2026.

How much does Amnio Wrap2 cost?

$1,950

Typical negotiated rate. In Pennsylvania, July 2026.

Insurers have agreed to pay about $1,950 for this service. The price depends on where it is billed: about $1,950 from a physician practice, and about $1,950 from a hospital or other facility. The two figures are alternatives, not parts of one bill.

These are rates insurers have negotiated with providers, not the amount a patient is billed. What you owe depends on your plan's deductible and coinsurance. Based on rates published by 7 insurance carriers under federal price transparency rules.

Where it's billed changes the price

Billed byTypicalRange
Physician practiceA doctor's office, clinic or independent provider$1,950$1,950 to $1,995
FacilityA hospital or hospital-owned outpatient department$1,950$1,698 to $1,995

How much rates vary

Facilitymedian $1,950 · 10th to 90th $214 to $1,995Professionalmedian $1,950 · 10th to 90th $126 to $2,042
$100.0$200.0$500.0$1.0K$2.0K$5.0Kfacility $1,950professional $1,950

Distribution of negotiated rates across all payers (price axis is log-scale). Each curve is scaled to its own total: facility and professional rates are different services, shown together to compare where they cluster. Need provider-level prices or 24+ months of history? Contact us.

Rates by insurance carrier

Insurance Carrier
Aetna
Setting
Facility
Modifier
Global
Typical Low
$1,949.84
Median
$1,949.84
Typical High
$1,995.26
Aetna
Setting
Professional
Modifier
Global
Typical Low
$1,949.84
Median
$1,949.84
Typical High
$2,041.74
Capital Blue Cross
Setting
Facility
Modifier
Global
Typical Low
$1,698.24
Median
$1,995.26
Typical High
$2,511.89
Capital Blue Cross
Setting
Professional
Modifier
Global
Typical Low
$1,995.26
Median
$1,995.26
Typical High
$1,995.26
Cigna
Setting
Facility
Modifier
Global
Typical Low
$125.89
Median
$446.68
Typical High
$478.63
Cigna
Setting
Professional
Modifier
Global
Typical Low
$125.89
Median
$125.89
Typical High
$125.89
Emblem Health
Setting
Professional
Modifier
Global
Typical Low
$154.88
Median
$275.42
Typical High
$2,041.74
Geisinger
Setting
Professional
Modifier
Global
Typical Low
$120.23
Median
$158.49
Typical High
$223.87
Martin's Point
Setting
Facility
Modifier
Global
Typical Low
$1,949.84
Median
$1,995.26
Typical High
$1,995.26
Martin's Point
Setting
Professional
Modifier
Global
Typical Low
$1,949.84
Median
$1,949.84
Typical High
$2,041.74
United
Setting
Facility
Modifier
Global
Typical Low
$154.88
Median
$154.88
Typical High
$154.88
United
Setting
Professional
Modifier
Global
Typical Low
$125.89
Median
$125.89
Typical High
$1,995.26

Where Pennsylvania sits

The same service costs 8.7 times more in California than in Minnesota. Every bar is a state, most expensive first. Pick one to see its carriers and full range.

Pennsylvania $1,950 · 36th of 51
CA $2,042MN $234

Median negotiated rate in each state, from every insurer that publishes one. States where no insurer publishes a rate for this service are not shown.